Megan Kristine Boucher, MA, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1655 Issued in ND

Practice address

4152 30TH Ave S Ste 102
Fargo, ND 58104-8403

Phone

(701) 551-1751

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flow Therapy Services, PLLC

  • Clinic/Center
  • Fargo, ND
  • NPI 1730973298
  NPD Authorized official
• Anne Carlsen Center

  • Physical Therapist
  • Jamestown, ND
  • NPI 1598930109

  Occupational Therapist

  NPD
• Myna Therapy Services PLLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1427788629

  Occupational Therapist

  NPD
• Great Kids Therapy, LTD.

  • Occupational Therapist
  • Fargo, ND
  • NPI 1497805196
  NPD (past)
• Myna Early Intervention LLC

  • Early Intervention Provider Agency
  • Fargo, ND
  • NPI 1639981343
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1952926396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4152 30TH AVE S STE 102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048403",
            "telephone_number": "701-551-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "MEGAN",
        "middle_name": "KRISTINE",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1655",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ND",
            "license": "1655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bossart Chiropractic Life Center PC
• Thomas David Bossart, D.C.
• Eva Louise Bostyan, LAC LSW
• Emma Botker, PT, DPT
• Brandon Botner
• Nicole Renae Boucher, SLP
• Tanner Boutain
• Michael S Bouton, MD
• Ann T Boutwell, RN
• Megan Bowen, MD

• Pediatric Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Pediatric Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.